Diagnostic accuracy of an international static-imaging telepathology consultation service

Halliday, Bradford E.; Bhattacharyya, Achyut K.; Graham, Anna R.; Davis, John R.; Leavitt, S. Anne; Nagle, Ray B.; McLAUGHLIN, W.J.; Rivas, Ricardo Alberto; Martinez, Ralph; Krupiński, Elizabeth A.; Weinstein, Ronald S.

doi:10.1016/s0046-8177(97)90273-2

Cited by 124 publications

(98 citation statements)

References 16 publications

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“…Telepathology is already integrated into histopathology services in other countries, despite similar initial reservations. [14][15][16][17][18][19][20] The ultimate role for telepathology in UK histopathology service delivery remains unclear. More evaluation and education are essential before significant resources are directed towards this technology.…”

Section: Discussionmentioning

confidence: 99%

“…Instant access to international expertise is also possible. 19 The technology could be used to maintain frozen section services to peripheral units without on site histopathologists. 18 20 With these potential advantages the uptake of telepathology has been low, with only 12% of respondents in our survey having access to a telepathology system, and 76% never having used a telepathology system.…”

Section: Discussionmentioning

confidence: 99%

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The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

Dennis

Start²,

Cross³

2005

J Clin Pathol

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Aims:To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology.Methods:A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK.Results:There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings.Conclusions:There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

Dennis

Start²,

Cross³

2005

J Clin Pathol

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“…Several studies have evaluated the diagnostic accuracy of static, dynamic and various hybrid forms of TP (1)(2)(3)(4)(5)(6)(7)(8). In many of these studies, the efficacy of evaluating cases by digital images proved to be quite reliable.…”

Section: Introductionmentioning

confidence: 99%

Variability in the diagnosis of dysplasia in ulcerative colitis by dynamic telepathology

et al. 2006

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Abstract. Telepathology (TP) is the practice of evaluating pathology cases by the digital transmission of diagnostic slides as either static pictures (static TP) or by a continuous flow of pictures from a robotic microscopy (dynamic TP). The diagnostic efficacy of dynamic TP-based consultation services has not been widely tested. Dysplasia arising in association with chronic ulcerative colitis (CUC) is, at present, the most important marker for an increased risk of malignancy in patients with this disease. However, the diagnosis of dysplasia suffers from a significant degree of intra-and interobserver variability which usually necessitates a second opinion prior to definitive treatment. Thus, it is often necessary to obtain expert consultation of potential dysplasia cases by dedicated gastrointestinal pathologists. The aim of this study was to evaluate the utility and interobserver variability of diagnosing dysplasia in CUC with the use of dynamic TP. Dynamic TP was used to evaluate digitalized images of 38 CUC cases with areas considered negative, indefinite, or positive for dysplasia (low or high grade) independently by seven pathologists. Subsequently, all cases were graded by each of the pathologists by light microscopic examination of the H&E-stained glass slides. The degree of intra-and interobserver variability was determined by Kappa statistics. Overall, there was a poor degree of interobserver agreement (K=0.32) among the seven pathologists after analysis of the cases by dynamic TP. The poorest level of agreement was in the indefinite and lowgrade dysplasia categories, whereas the highest level was in the negative and high-grade dysplasia categories. Grouping together several diagnostic categories (for instance: Indefinite and low, or low-and high-grade dysplasia) had no significant effect on the level of agreement. The degree of variability in interpretation of cases by microscopic slide analysis was similar (K=0.35). After reviewing all the cases by microscopic analysis of the glass slides, the diagnosis was changed in 51% of the observations; in the majority of these (61%), the grade of dysplasia was decreased. In summary, the use of dynamic TP for consultation in CUC-associated dysplasia has a poor level of interobserver agreement, but does not differ significantly from that obtained by the evaluation of the cases by microscopic slide analysis. Diagnoses rendered by dynamic TP tend to be of a higher grade compared to that obtained by microscopic slide analysis. Thus, although dynamic TP may be used for the consultation of CUC dysplasia cases, more specific criteria are needed in the general categorization of dysplasia in CUC.

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“…There have been studies using offline telepathology as a second opinion service for a variety of "difficult" cases, which have shown reasonable degrees of concordance between the telepathology and glass slide diagnoses (∼ 75%). [12][13][14] There has been one published study using offline telepathology to make diagnoses in a large series of prostate needle core biopsies, but these cases were all secondary referral consultations. 15 We have not identified any published studies using offline telepathology as a primary diagnostic modality for routine histopathology specimens.…”

mentioning

confidence: 99%

Offline telepathology diagnosis of colorectal polyps: a study of interobserver agreement and comparison with glass slide diagnoses

Cross¹,

Burton²,

Dube³

et al. 2002

Journal of Clinical Pathology

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Background/Aims: Technological advances have produced telepathology systems with high quality colour images and reasonable transmission times. Most applications of telepathology have centred on the remote diagnosis of frozen sections or remote real time expert opinions. This study investigates the reproducibility and accuracy of offline telepathology as a primary diagnostic medium for routine histopathology specimens. Methods: One hundred colorectal polyps (50 hyperplastic, 50 adenomatous) were presented in a randomised order to five histopathologists as offline images on a telepathology workstation. Six images of each case were used: the slide label, a low power scan of all material on the slide, and four higher magnification views. The times taken to prepare the images, and to make the diagnoses, were recorded. Interobserver agreement was measured with κ statistics and compared with the glass slide diagnoses. Results: The κ statistics for the interobserver agreement on the telepathology images lay in the range of 0.90-1.00, which is interpreted as excellent agreement, and were significantly higher than those for the glass slide diagnoses (range, 0.84-0.98; p = 0.001). The median time taken to capture the images for a case was 210 seconds. The median time taken to make a diagnosis from the telepathology images was five seconds, which was significantly shorter than for the glass slide diagnoses (median, 13 seconds; p < 0.0005). Conclusions: Offline telepathology has the potential to be a primary diagnostic medium for routine histopathology with a high degree of reproducibility and short diagnosis times. Further studies are required to validate offline telepathology for different types of specimens and different operators of the image capture system.

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Diagnostic accuracy of an international static-imaging telepathology consultation service

Cited by 124 publications

References 16 publications

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

Variability in the diagnosis of dysplasia in ulcerative colitis by dynamic telepathology

Offline telepathology diagnosis of colorectal polyps: a study of interobserver agreement and comparison with glass slide diagnoses

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